For severely obese patients, weight loss surgery or bariatric surgery may be an option when non-surgical treatments fail. With dietary changes and an active lifestyle, bariatric surgery helps patients lose pounds and maintain a healthy weight.
There are three types of bariatric surgery procedures that may be recommended. Each uses different techniques to interrupt digestion or reduce the amount of food the patient eats.
The laparoscopic adjustable gastric band (LAGB), or lap band surgery, stimulates weight loss by restricting the amount of food that can be eaten. The LAGB is an inflatable band placed around the upper portion of the stomach, creating a small stomach pouch above the band, leaving the rest of the stomach intact below. With the smaller stomach pouch, eating just a small amount of food will satisfy hunger and promote the feeling of fullness. The feeling of fullness depends upon the size of the opening between the pouch and the remainder of the stomach created by the gastric band. The size of the stomach opening can be adjusted by filling the band with sterile saline, which is injected through a port placed under the skin. This is done gradually over time with repeated ‘fills.’ The LAGB involves no cutting or stapling of the stomach or intestines; it is both adjustable and reversible.
Roux-en-Y Gastric Bypass
This surgical option reduces the amount of food that the stomach can hold and decreases the amount of nutrients that are digested and absorbed. The Roux-en-Y Gastric Bypass (RYGB) surgery divides the stomach in two to create a small ‘upper stomach’ pouch. The stomach pouch is approximately the size of your thumb and holds only about 3 tablespoons of food. After the pouch is formed, the second part of the small intestine is cut and the lower portion of the cut intestine is attached to the stomach pouch. Food now passes from the mouth through the esophagus to the small stomach pouch and directly into the second part of the small intestines—bypassing the larger part of the stomach and the first portion of the small intestine, which results in less digestion and less absorption of nutrients consumed.
The larger bypassed stomach portion maintains its blood supply and—although it no longer has food passing through it—the smell, taste, chewing and swallowing of food stimulate the stomach to continue to produce gastric juices that eventually mix with food in the small intestines.
RYGB is considered the ‘gold standard’ of weight loss surgery because of its effectiveness in helping patients reduce body mass, medications and the likelihood of additional surgeries. At the Metabolic Medicine and Surgery Institute, the RYGB is performed robotically. Due to greatly improved visualization and precision, robotic surgery has benefits above and beyond routine laparoscopic surgery procedures.
• Shorter hospital stay
• Less pain and decreased need for pain medication
• Fewer intra-operative complications
• Safer procedure for extremely obese patients
The Sleeve Gastrectomy involves the removal of 75 to 80 percent of the stomach, leaving a banana-shaped tubular stomach. The functional volume of the stomach is greatly reduced, but the passage of the food stream is not altered. This not only restricts the amount of food that can be eaten, but also causes changes in the production of certain gastrointestinal hormones that reduce hunger and appetite. Early comparative studies show the Sleeve Gastrectomy to be equally effective to the gastric bypass in terms of weight loss and diabetes improvement/remission in the short term, but long term, data is lacking.
While these procedures are effective in reducing patient’s weight, they are serious surgical procedures that may cause side effects. Find out more about weight loss surgery to determine if you are a candidate for Florida Hospital’s minimally invasive procedures. Schedule an appointment online today.